The present invention relates generally to dentistry tools and, more specifically, to a versatile and ergonomic system for manipulation of dental appliances.
Dentistry, particularly restorative dentistry, is a demanding craftxe2x80x94requiring a skillful blend of structural engineering and aesthetics. Dentists must artfully construct and shape what are often very complicated restorative structures while working within the confined space of a patient""s mouth. Further complicating this already challenging task are safety and sanitary requirements, ergonomic problems, and concerns about patient comfort. At its best, such work might be considered tedious. At its worst, such work might be considered nearly impossible.
As a result, a number of devices and methodologies have been developed to aid dentists in performing routine procedures. Specialized handpieces, powered tools, shielding and grasping devices are continually developed to assist in nearly every aspect of routine dentistry. Often times, however, the development of one aid may simplify a particular aspect of a procedure while complicating other aspects of the same procedure. Furthermore, there are a number of routine procedures, for which no specialized tools exist, that require dentists to utilize existing devices in an unintended fashion. Thus, restorative dentistry often relies on both specialization and improvisation.
Consider, for example, the tools and procedures involved in filling interproximal cavities. Depending upon the location and size of the filling needed, a dentist may have a very difficult time forming a filling of proper structural integrity that provides a desired aesthetic appearance and proper interproximal contact. A relatively popular method of interproximal filling relies on the use of sectional matrix bands.
Sectional matrix bands are small appliances that serve, essentially, as a form for interproximal fillings (especially bonded fillings) when some portion of the external tooth structure is missing or has been removed. The bands are used to restore the tooth structure to its natural contour, without having to dispose excessive bonding material in the area surrounding the filling. These matrix bands are generally formed of aluminum or some other similar semi-rigid material, and typically come in a number of sizes to match tooth and filling sizes. The bands usually have some degree of concavity, in addition to multiple degrees of curvature, to match the often asymmetrical, quasi-spherical contour of a tooth. After proper placement and seating, the matrix bands are usually held in place by some sort of matrix retainer (e.g., a wedge or bi-tine ring).
Thus, once a sectional matrix band is in place, the filling procedure is significantly simplified. The proper placement and seating of a sectional matrix band is, however, no trivial task. It is, in fact, a task that appears to be widely recognized as difficult and involvedxe2x80x94and one for which conventional apparatus and methods are not properly adapted.
Conventionally, sectional matrix bands have been placed using only the dentist""s fingers, or placed by simple tweezers, straight pliers, or even cotton pliers. These conventional methods share a number of common problems and challenges, and each individual method presents its own unique problems and concerns.
One primary concern is maintaining the integrity of the matrix band itself. Until properly placed, the band is highly susceptible to bending and crimping. This can lead to unacceptable deformities in the band, requiring removal and placement of a new band, or acceptance of a structurally or aesthetically inferior filling.
Even the most nimble of dentists, with the daintiest of fingers, may have difficulty working within the limited space of a patient""s mouth to properly place a sectional matrix band without deforming the band. The location of the required filling can further complicate the procedure. The further posterior the required filling is (e.g., between molars), or if the filling is on the mesial surface of a tooth, the more difficult it is to manually place the small, flexible sectional matrix bands. Furthermore, placement by finger may be much more difficult for dentists with larger hands.
Conventional placement methods typically require a great deal of manipulation at ergonomically awkward angles for a dentist. That ergonomically improper manipulation might, over time, lead to degenerative neuromuscular problems. Furthermore, if there is strong interproximal contact between the teeth, the dentist must either ply the teeth apart, such that the instrument used to ply the teeth apart does not impede the placement of the band, or break interproximal contact, in order to place the band without deforming it. Breaking interproximal contact may require removal of an excessive (i.e., unacceptable) amount of tooth structure, however, especially where only a small filling is required.
Although some conventional methods of sectional matrix band placement utilize conventional, general-purpose instruments (e.g., conventional tweezers and pliers)xe2x80x94thereby reducing some of the problems associated with working in the confined space of a patient""s mouthxe2x80x94extensive instrument manipulations, ergonomic challenges, and increased potential for damage to the band remain problematic. Using such conventional instruments may still be difficult for posterior placements.
Furthermore, such general-purpose instruments are typically unsuitable for firmly grasping and manipulating the curved sectional matrix bands without deformation. Most such instruments have flat, planar grasping surfaces that can bend or damage a matrix band. The grasping surfaces themselves are generally not arcuate in nature, and thus will not tightly grasp a significant cross section of a sectional matrix band without deformation. Finally, most such conventional instruments are not curved or angled to provide reliable sectional matrix band disposition in both distal and mesial orientations.
More recently, some efforts have been made to redesign or adapt conventional instruments especially for use in sectional matrix band placement. Typically, such adaptations comprise a single, planar angulation or curvature of the grasping end of a simple tweezer or plier-type assembly. Although such adaptations might reduce some of the difficulty in the placement of sectional matrix bands, the full benefit of specialized instruments remains unrealized. For example, conventional instruments typically remain unbiased toward either mesial or distal orientations. Moreover, such instruments typically remain unsuitable for firmly grasping and manipulating the curved sectional matrix bands without deformation. Most such instruments have flat grasping surfaces that are not capable of tightly grasping a significant cross section of a sectional matrix band without deformation.
Thus, sectional matrix band placement is often tedious, time-consuming and, in some cases, not possible using conventional instruments.
A system that provides easy and reliable placement and removal of specially contoured dental appliances, such as sectional matrix bands, while maintaining the structural and aesthetic integrity of the appliance, readily usable for both distal and mesial manipulations in an ergonomically proper manner, is now needed. This system should provide dentists with a tool that simplifies restorative procedures without deforming or damaging the appliances being placed. The system should thus provide relief from problems associated with conventional methods and apparatus.
Comprehending this, the present invention provides a versatile system for the efficient manipulation of specially contoured dental appliances, especially sectional matrix bands. The present invention provides a contoured grasping member assembly for grasping the dental appliance. The grasping members may be contoured in a variety of topologies and orientations, such that their contour closely approximates the contour of an appliance to be manipulated. Such contouring may be formed in vertical, lateral, or a combination of vertical and lateral, planes using combinations of straight, curved, or angled surfaces. Angulation, curvature, or other deformation may further be employed to facilitate manipulations in distal, mesial, or both mesial and distal orientations.
The present invention also provides an actuating assembly, to which the grasping member assembly may be permanently or temporarily attached, for actuating the grasping member assembly. In the actuating assembly, or in its coupling to the grasping member assembly, angulation, curvature or other deformation may also be employed to facilitate manipulations in distal, mesial, or both mesial and distal orientations. The actuating assembly may be configured such that actuation increases pressure between the grasping members, or configured such that actuation decreases pressure between the grasping members, depending upon the desired orientation and performance characteristics.
The grasping member, or members, on one side of the assembly may include an apical seating feature disposed along an upper edge, to secure the appliance in place and assist in applying seating pressure to the appliance.
Other features and advantages of the present invention will be apparent to those of ordinary skill in the art upon reference to the following detailed description taken in conjunction with the accompanying drawings.